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- Ederle, Joerg, et al.
(författare)
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Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial
- 2010
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Ingår i: The Lancet. - 1474-547X. ; 375:9719, s. 985-997
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Tidskriftsartikel (refereegranskat)abstract
- Background Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy. Methods The International Carotid Stenting Study (ICSS) is a multicentre, international, randomised controlled trial with blinded adjudication of outcomes. Patients with recently symptomatic carotid artery stenosis were randomly assigned in a 1:1 ratio to receive carotid artery stenting or carotid endarterectomy. Randomisation was by telephone call or fax to a central computerised service and was stratified by centre with minimisation for sex, age, contralateral occlusion, and side of the randomised artery. Patients and investigators were not masked to treatment assignment. Patients were followed up by independent clinicians not directly involved in delivering the randomised treatment. The primary outcome measure of the trial is the 3-year rate of fatal or disabling stroke in any territory, which has not been analysed yet. The main outcome measure for the interim safety analysis was the 120-day rate of stroke, death, or procedural myocardial infarction. Analysis was by intention to treat (ITT). This study is registered, number ISRCTN25337470. Findings The trial enrolled 1713 patients (stenting group, n=855; endarterectomy group, n=858). Two patients in the stenting group and one in the endarterectomy group withdrew immediately after randomisation, and were not included in the ITT analysis. Between randomisation and 120 days, there were 34 (Kaplan-Meier estimate 4.0%) events of disabling stroke or death in the stenting group compared with 27 (3.2%) events in the endarterectomy group (hazard ratio [HR] 1.28, 95% CI 0.77-2.11). The incidence of stroke, death, or procedural myocardial infarction was 8.5% in the stenting group compared with 5.2% in the endarterectomy group (72 vs 44 events; HR 1.69, 1.16-2.45, p=0.006), Risks of any stroke (65 vs 35 events; HR 1.92, 1.27-2.89) and all-cause death (19 vs seven events; HR 2.76, 1.16-6.56) were higher in the stenting group than in the endarterectomy group. Three procedural myocardial infarctions were recorded in the stenting group, all of which were fatal, compared with four, all non-fatal, in the endarterectomy group. There was one event of cranial nerve palsy in the stenting group compared with 45 in the endarterectomy group. There were also fewer haematomas of any severity in the stenting group than in the endarterectomy group (31 vs 50 events; p=0.0197). Interpretation Completion of long-term follow-up is needed to establish the efficacy of carotid artery stenting compared with endarterectomy. In the meantime, carotid endarterectomy should remain the treatment of choice for patients suitable for surgery.
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- Parnanen, P, et al.
(författare)
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Antimicrobial and Anti-inflammatory Lingonberry Mouthwash - A Clinical Pilot Study in the Oral Cavity
- 2019
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Ingår i: Microorganisms. - : MDPI AG. - 2076-2607. ; 7:9
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Tidskriftsartikel (refereegranskat)abstract
- Fermented lingonberry juice was designed to be used as a mouthwash. Our aim was to study the antimicrobial and anti-inflammatory effects of the mouthwash in the oral cavity. A clinical study of 30 adult participants was performed. A total of 20 participants used 10 mL of the mouthwash twice daily for two weeks and 10 participants used 20 mL twice daily for one week. Streptococcus mutans, Candida and Lactobacilli were cultivated at the beginning, after the mouthwash period and after a washout period. At the same timepoints an additional oral mouthrinse was collected for chair-side/point-of-care (POC)-PerioSafe®/OraLyzer® aMMP-8 quantitative on-line evaluation, and an oral clinical investigation was performed. Mean Streptococcus mutans and Candida counts, visible plaque index (VPI) and bleeding on probing (BOP) were reduced, and Lactobacilli counts increased during the lingonberry mouthwash period. The aMMP-8 mouthrinses showed reduced values in both test groups when compared to the startpoint. The mouthrinse aMMP-8 reduction correlated with the reductions in microbial counts, VPI and BOP. Based on the results, fermented lingonberry juice seems a promising aid in oral homecare, diminishing the microbial and related proinflammatory burden by balancing the oral microbial flora and gradually lowering the inflammatory load in the oral cavity.
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- Ravinath, Harinath, et al.
(författare)
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Impact of aging temperature on the metallurgical and dry sliding wear behaviour of LM25 / Al2O3 metal matrix composite for potential automotive application
- 2023
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Ingår i: International Journal of Lightweight Materials and Manufacture. - : Elsevier BV. - 2588-8404. ; 6:3, s. 416-433
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Tidskriftsartikel (refereegranskat)abstract
- The current study exhibits the influence of aging temperatures on the metallurgical, hardness, and dry-sliding wear behaviour of LM25 (Al-6.6Si-0.2Mg) alloy reinforced with Al2O3 particles. The LM25 alloy reinforced with 10 wt% of alumina particles was fabricated using the liquid metallurgy route followed by solutionizing and aging. The baseline LM25 alloy and its composite were solutionized at 538 °C for 8 h and were aged at 155, 165, and 175 °C for 12 h. Optical, FESEM, EDS, and X-ray diffraction analysis were done on the fabricated alloy and its composite in all conditions. The microstructure revealed the formation of the Mg2Si phase in the baseline alloy and the MgAl2O4 spinel generated at the composite interface of the aluminium matrix. The heat-treated alloy and composites were tested for their hardness on the Vickers microhardness tester. It was concluded that the aging temperature of 155 °C displayed significant enhancement in hardness values for tested samples. The heat-treated alloy and composite samples displayed an increment of 96% and 55% in hardness values relative to LM25. The wear rate and friction coefficient for the fabricated samples were analyzed using the pin-on-disc tribometer under dry sliding conditions. The hardness value increased from the as-cast state to samples aged at 155 °C and then decreased at 165 and 175 °C. Based on the wear study, a 14% and 25% decrease in the wear rate values for heat-treated alloy and composites were noted when sliding velocity was increased from 1 m/s to 3 m/s. However, the coefficient of friction (COF) decreased by 23% and 13% for the specimens in the same conditions. Furthermore, a similar trend was displayed by age-hardened LM25 alloy and the composite when subjected to varying load (5, 10, 15 N) condition. Lastly, the worn-out surface mechanisms were examined using FESEM analysis. Amongst the investigated samples, LM25/10 wt% Al2O3 composite aged at 155 °C revealed the least wear rate when subjected to an external load of 5 N and sliding velocity of 2 m/s. Therefore, it can be suggested to manufacture components in the automotive industry.
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